Medical tests and treatments you should question

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Nine medical societies have released a list of 45 tests and treatments that patients should question and doctors should avoid in most cases as part of an effort to cut wasteful spending. Here is a sample:

_ Don’t do MRI’s or other imaging scans for low back pain within the first six weeks, unless serious underlying conditions are suspected. (American Academy of Family Physicians)

_ Don’t do brain CT scans or MRI’s on patients who have fainted with no evidence of seizures or neurological problems. (American College of Physicians)

_ Don’t treat tumors in end-stage cancer patients whose disease has failed to respond to multiple curative therapies, are ineligible for experimental treatments, are confined to a bed or chair more than half the day, and there is an absence of evidence supporting clinical value of further anti-cancer treatment. (American Society of Clinical Oncology)

_ Don’t order CT scans or prescribe antibiotics for patients with uncomplicated upper respiratory conditions. (American Academy of Allergy, Asthma & Immunology)

_ Avoid routine pre-hospital admission or preoperative chest X-rays for patients with no indication of heart or lung disease. (American College of Radiology)

_ Do not repeat colorectal cancer screening by any method for 10 years after negative results from a high-quality colonoscopy in patients with an average risk profile. (American Gastroenterological Association)

_ Don’t perform sophisticated cardiac imaging tests on patients who have a low risk of heart attack or death based on physical examination and other markers. (American Society of Nuclear Cardiology)

_ Don’t start long-term kidney dialysis without a thorough discussion and shared decision-making process including patient and family. (American Society of Nephrology)

_ Don’t perform stress cardiac imaging on patients without heart symptoms unless they are in high-risk groups, such as diabetics. (American College of Cardiology)

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Online: www.choosingwisely.org

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